DISTANCE MEASURING MODELING AND ERROR ANALYSIS OF DUALCCD VISION SYSTEM SIMULATING HUMAN EYES AND NECK

A dual-CCD simulating human eyes and neck (DSHEN) vision system is putforward. Its structure and principle are introduced. The DSREN vision system can perform somemovements simulating human eyes and neck by means of four rotating joints, and realize preciseobject recognizing and distance measuring in all orientations. The mathematic model of the DSHENvision system is built, and its movement equation is solved. The coordinate error and measureprecision affected by the movement parameters are analyzed by means of intersection measuringmethod. So a theoretic foundation for further research on automatic object recognizing and precisetarget tracking is provided.

Clinical and scientific impact of human papillomavirus on head and neck cancer

Head and neck cancer(HNC) arises from the skull base to the clavicles and is the fifth most common cancer in the world by incidence. Historically, in the developed world HNC was associated with tobacco use and alcohol consumption, and the combination of the two produced a synergistic increase in risk. However, beginning in 1983, investigators have found a significant and growing proportion of HNC patients with human papillomavirus-positive(HPV) tumors who neither drank nor used tobacco. Since that time, there has been increased interest in the molecular biology of HPV-positive HNC. Multiple studies now show that HPV has shifted the epidemiological landscape and prognosis of head and neck squamous cell carcinoma(HNSCC). These studies provide strong evidence for improved survival outcomes in patients with HPV-positive HNSCC compared to those with HPV-negative HNSCC. In many reports, HPV status is the strongest predictor of locoregional control, disease specific survival and overall survival. In response to these findings, there has been significant interest in the best management of HPV-positive disease. Discussions within major cooperative groups consider new trials designed to maintain the current strong survival outcomes while reducing the long-term treatment-re-lated toxicities. This review will highlight the epidemiological, clinical and molecular discoveries surrounding HPV-related HNSCC over the recent decades and we conclude by suggesting how these findings may guide future treatment approaches.

Multimodality functional imaging using DW-MRI and 18F-FDG-PET/CT during radiation therapy for human papillomavirus negative head and neck squamous cell carcinoma: Meixoeiro Hospital of Vigo Experience

AIM To noninvasively investigate tumor cellularity measured using diffusion-weighted magnetic resonance imaging(DW-MRI) and glucose metabolism measured by 18 Flabeled fluorodeoxyglucose positron emission tomography/computed tomography(18F-FDG-PET/CT) during radiation therapy(RT) for human papillomavirus negative(HPV-) head and neck squamous cell carcinoma(HNSCC).METHODS In this prospective study, 6 HPV- HNSCC patients underwent a total of 34 multimodality imaging examinations(DW-MRI at 1.5 T Philips MRI scanner [(n = 24) pre-, during-(2-3 wk), and post-treatment(Tx), and 18F-FDG PET/CT pre- and post-Tx(n = 10)]. All patients received RT. Monoexponential modeling of the DW-MRI data yielded the imaging metric apparent diffusion coefficient(ADC) and the mean of standardized uptake value(SUV) was measured from 18F-FDG PET uptake. All patients had a clinical follow-up as the standard of care and survival status was documented at 1 year.RESULTS There was a strong negative correlation between the mean of pretreatment ADC(ρ =-0.67, P = 0.01) and the pretreatment 18F-FDG PET SUV. The percentage(%) change in delta(?) ADC for primary tumors and neck nodal metastases between pre- and Wk2-3 Tx were as follows: 75.4% and 61.6%, respectively, for the patient with no evidence of disease, 27.5% and 32.7%, respectively, for those patients who were alive with disease, and 26.9% and 7.31%, respectively, for those who were dead with disease.CONCLUSION These results are preliminary in nature and are indicative, and not definitive, trends rendered by the imaging metrics due to the small sample size of HPV- HNSCC patients in a Meixoeiro Hospital of Vigo Experience.

3D Vector Reconstruction of the Neck Skeleton from the Anatomical Sections of Korean Visible Human at the Anatomical Laboratory of Paris Descartes

Aim: To perform a vector 3D reconstruction of the neck skeleton from the anatomical sections of the “Korean Visible Human” for educational purposes. Material and Methods: The anatomical subject was a 33-year-old Korean male who died of leukemia. It measured 164 cm and weighed 55 kgs. The anatomical cuts were made in 2010 after an MRI and a CT scan. A special saw (cryomacrotome) made it possible to make cuts on the frozen body of 0.2 mm thick or 5960 slices. Sections numbered 1500 to 2000 (500 neck sections) were used for this study. Manual contouring segmentation of each anatomical element of the anterior neck area was done using Winsurf software version 3.5 on a PC. Results: Our vector 3D neck model includes the following: cervical vertebrae, hyoid bone, sternum manubrium and clavicles. This vector model has been integrated into the virtual dissection table Diva3d, a new educational tool used by universities and medical schools to learn anatomy. This model was also put online on the Sketchfab website and printed in 3D using an ENDER 3 printer. Conclusion: This original work is a remarkable educational tool for the study of the skeleton of the neck and can also serve as a 3D atlas for simulation purposes for training therapeutic gestures.

3D Vector Reconstruction of the Muscles of the Ventral Region of the Neck from Anatomical Sections of Korean Visible Human at the Paris Descartes Anatomy Laboratory

Objective: To carry out a 3D vector reconstruction of the muscles of the ventral region of the neck from anatomical sections of the “Korean Visible Human” for educational purposes. Materials and Methods: The anatomical subject was a 33-year-old Korean man who died of leukemia. He was 164 cm tall and weighed 55 kgs. The anatomical sections were made in 2010 after an MRI and a CT scan. A special saw (cryomacrotome) made it possible to make cuts 0.2 mm thick on the frozen body, i.e. 5960 cuts. Sections numbered 1500 to 2000 (or 500 cuts covering the neck) were used for our study. A segmentation by manual contouring of each anatomical element of the anterior neck region was done using Winsurf version 3.5 software on a laptop PC running Windows 7 equipped with an 8 gigabyte RAM. Results: We modeled the sternocleidomastoid muscles, the supra-hyoid muscles, the infra-hyoid muscles and the muscle structures of the anterior neck region, the aero-digestive axis of the anterior neck region and the vasculo-nervous axis of the neck. This model is easily manipulated using the Acrobat 3Dpdf interface. Each item accessible in a menu can be displayed, hidden or made transparent, and 3D labels are available as well as educational menus for learning anatomy. This vector model has been integrated into the Diva3d virtual dissection table, a new educational tool used by universities and medical schools to learn anatomy. This model was also uploaded to the Sketchfab? website and 3D printed using an ENDER? pro 3 printer. Conclusion: This original work constitutes a remarkable educational tool for the anatomical study of the anterior neck region and can also be used as a 3D atlas for simulation purposes for training in therapeutic gestures.

基于改进YOLO-Pose轻量模型的多人姿态估计

YOLO-Pose作为人体姿态估计算法模型,在精度和速度上有着不错的表现,但其在复杂和有遮挡的场景下存在误检率较大的问题,并且模型的复杂度仍然有优化的空间.针对这几个问题,通过选取Slim-neck模块和Res2Net模块,重新设计其特征融合层,减少其计算量和参数量,提高特征提取能力,在提升精度的同时,使模型轻量化;引入EIoU损失函数,加快边框检测的收敛速度,并提高定位的准确性.在压缩的OC_Human数据集上进行测试,改进后的模型与YOLO-Pose相比,P值、mAP@0.5和mAP@.5:95分别提高了10.6,3.1和2.9个百分点.此外,参数量和计算量也分别减少了16.7%和19.3%,在精度和轻量化方面均有所提升,为其应用在资源有限的边缘计算设备提供了可能性.

超声NT及LC联合母血分子标志物评估高危妊娠产妇妊娠结局的价值

目的:探讨超声颈项透明层厚度(NT)、子宫颈长度(LC)联合游离人绒毛膜促性腺激素(B-HCG)、妊娠相关血浆蛋白(PAPPA)、D二聚体(D-D)评估高危妊娠产妇妊娠结局的价值。方法:回顾性选取2019年1月至2022年1月在我院就诊的高危妊娠产妇80例作为研究对象,根据是否发生不良妊娠结局分为有不良妊娠结局组和无不良妊娠结局组,比较两组NT、LC、动脉S/D、PI、RI以及血清B-HCG、PAPPA、D-D的差异,以及指标间的相关性和对不良妊娠结局的预测价值。结果:有不良妊娠结局产妇的B-HCG、PAPPA、D-D和NT分别为(2.28±0.62)mom、(0.72±0.16)mom、(351.12±82.80)mg/L和(3.78±0.81)mm,明显高于无不良妊娠结局产妇(1.75±0.41)mom、(0.57±0.15)mom、(295.33±85.52)mg/L和(3.31±0.64)mm(P<0.01),而LC为(24.49±4.53)mm,明显低于无不良妊娠结局产妇(31.01±5.12)mm(P<0.01)。B-HCG、PAPPA、D-D水平与NT呈正相关(P<0.05),而与LC呈负相关(P<0.05)。NT、LC联合B-HCG、PAPPA、D-D预测高危妊娠产妇不良妊娠结局的ROC曲线下面积为0.911(95CI:0.848~0.974),明显高于各指标单独预测,其灵敏性和特异性分别为79.20%和96.30%,P<0.01。结论:NT、LC及B-HCG、PAPPA、D-D与高危妊娠产妇不良妊娠结局有相关性,在预测高危妊娠产妇不良妊娠结局中有较好的价值。

程序性死亡受体/配体免疫治疗策略在人乳头瘤病毒阳性头颈部鳞状细胞癌中的研究进展

人乳头瘤病毒(HPV)感染已成为头颈部鳞状细胞癌(HNSCC)的主要致病因素之一,与HPV阴性相比,HPV阳性HNSCC表现出以程序性死亡受体(PD)为代表的多种免疫细胞及其效应分子的表达增加。PD-1/PD-L1高表达的患者与HPV阳性HNSCC患者存活率的显著提高相关。而HPV阳性HNSCC患者在接受抗PD-1/程序性死亡配体(PD-L1)免疫治疗后的客观缓解率、无进展生存期、总生存期等指标较HPV阴性HNSCC患者有所提高,提示HPV阳性HNSCC患者在接受抗PD-1/PD-L1免疫治疗上可能取得更好疗效。另外,PD-1/PD-L1抑制剂联合HPV癌症疫苗、双通路抑制剂等免疫治疗方案在HPV相关癌症中已发挥出独特的优势。根据HPV状态为患者制定个体化免疫治疗是一种有前景的治疗策略。

头颈部黏膜病损中拭子HPV半定量检测的应用研究

目的比较头颈部黏膜病损HPV E6/E7 mRNA的半定量检测与组织中p16免疫组织化学染色及E6/E7RNA原位杂交检测的一致性,探讨应用咽拭子检出头颈部黏膜病损中高危型HPV感染的可行性。方法收集2022年9月~2023年8月首都医科大学附属北京同仁医院头颈外科经治的头颈部黏膜病损患者100例,进行口咽、病损表面拭子和病损组织标本HPV E6/E7 mRNA的半定量检测和病损组织的p16免疫组织化学染色、E6/E7 mRNA原位杂交检测,并对不同检测结果的一致性和差异性进行研究。结果100例患者中,符合纳排标准者共83例,其中乳头状瘤21例、息肉/慢性炎症10例、喉癌19例、口咽癌13例、下咽癌20例。口咽拭子和病损表面拭子的HPV E6/E7 mRNA半定量检测结果与p16免疫组织化学染色结果表现为中度或接近高度的一致性,而病损组织的HPV E6/E7 mRNA半定量检测结果与p16免疫组织化学染色表现为高度的一致性(Kappa=0.780);在诊断效能分析中,两种拭子均表现出与HPVE6/E7mRNA原位杂交高度的一致性(Kappa=0.690、0.708)。结论在头颈部黏膜病损中,口咽和病损表面拭子的HPV半定量检测结果与经典的p16免疫组织化学染色及“金标准”HPV E6/E7 mRNA原位杂交相比较具有较好的一致性,是一种简便可靠的临床高危型HPV检出方法,有助于头颈部黏膜病损HPV感染的筛查和个体化精准防控。

门诊人性化管理模式在耳鼻咽喉头颈外科的应用探讨

目的:探讨门诊人性化优质护理服务在耳鼻咽喉头颈外科的应用,评价患者焦虑情绪、服药依从性和护理满意度。方法:回顾性分析2023年5月-2023年08月耳鼻喉科门诊复诊患者172例,按照门诊就诊的时间先后顺序编号,单号为观察组,双号为对照组,每组各86人。对照组给予常规护理服务,观察组在此基础上行人性化优质护理服务。比较两组患者在不同护理服务方式的应用效果。观察患者焦虑情绪、服药依从性和护理满意度评分情况。结果:观察组患者SAS评分高于对照组,差异有统计学意义(P<0.05)。观察组患者服药依从性高于对照组,差异有统计学意义(P<0.05)。观察组患者护理满意度高于对照组(P<0.05)。结论:实施人性化优质护理服务在门诊耳鼻咽喉头颈外科的应用,进一步优化服务流程,改善患者焦虑情绪。建立以患者为中心的服务管理模式,提高患者服药依从性,从而提升患者对护理工作的满意度。

Bilateral sequential femoral neck stress fractures in young adult with HIV infection on antiretroviral therapy: A case report

BACKGROUND Femoral neck stress fractures are rarely encountered among young adults and are often associated with either repetitive excessive loading or underlying bone pathology.Preliminary research has indicated human immunodeficiency virus(HIV)/antiretroviral therapy(ART)as predisposing agents to osteopenia and osteoporosis related complications.We report a case of HIV/ART induced insufficiency fracture in a resource limited setting in Central India.Our aim is to increase awareness and promote screening of HIV/ART related osteopenia and osteoporosis in order to prevent catastrophic orthopaedic complications.CASE SUMMARY A 35-year-old HIV positive male presented with a stress fracture of left femoral neck.The patient was on ART and reported no comorbidities.He went on to be successfully managed surgically.However,during work-up osteopenia of the contralateral proximal femur was recognised using Singh’s Index.Six months post-op the patient presented with right-sided femoral-neck stress fracture.At this stage the patient was nonconcordant with ART and denied surgical fixation.CONCLUSION In the absence of co-morbidities,several mechanisms of HIV/antiretroviral therapy may have played a role in predisposing our patient towards such a presentation.We recommend routine screening all HIV-infected patients for osteopenia,especially in younger individuals.In low resource settings and district hospitals,pelvis radiograph&Singh’s index can be used for screening.

Role of human papillomavirus in oropharyngeal squamous cell carcinoma: A review

Human papillomavirus(HPV) has been implicated in the pathogenesis of a subset of oropharyngeal squamous cell carcinoma. As a result, traditional paradigms in relation to the management of head and neck squamous cell carcinoma have been changing. Research into HPVrelated oropharyngeal squamous cell carcinoma is rapidly expanding, however many molecular pathological and clinical aspects of the role of HPV remain uncertain and are the subject of ongoing investigation. A detailed search of the literature pertaining to HPV-related oropharyngeal squamous cell carcinoma was performed and information on the topic was gathered. In this article, we present an extensive review of the current literature on the role of HPV in oropharyngeal squamous cell carcinoma, particularly in relation to epidemiology, risk factors, carcinogenesis, biomarkers and clinicalimplications. HPV has been established as a causative agent in oropharyngeal squamous cell carcinoma and biologically active HPV can act as a prognosticator with better overall survival than HPV-negative tumours. A distinct group of younger patients with limited tobacco and alcohol exposure have emerged as characteristic of this HPV-related subset of squamous cell carcinoma of the head and neck. However, the exact molecular mechanisms of carcinogenesis are not completely understood and further studies are needed to assist development of optimal prevention and treatment modalities.

基于股骨颈截面形态调整术中C臂机的透视角度

目的根据股骨颈截面实体解剖特点,探讨完整显影股骨颈解剖结构的术中C形臂X线透视角度。方法观察并测量股骨颈截面解剖参数,将组成股骨颈的3个主要曲面(前曲面、后上曲面及后下曲面)分别用铝箔纸贴附,做成股骨颈的曲面透视模型。以股骨颈中点为投照中心点,设定0°~170°之间每间隔10°旋转C形臂,依次3种铝箔纸模型分别进行X线投照,取铝箔纸显影呈最小时的透视角度为该曲面的适宜投照角度。3枚克氏针分别穿出股骨颈前曲面、后上曲面及后下曲面做成股骨颈内固定穿出模型,用传统正、侧位以及实验所获得的3个适宜投照角度共5个角度透视,观察穿出股骨颈克氏针的显影情况。结果股骨颈3个主要曲面长度占股骨颈周长的80.95%,其前曲面冠状角为18°,后上曲面冠状角为65°,后下曲面冠状角为165°,3个曲面的适宜投照角度分别为20°、70°和170°,在这3个投照角度的影像上,可以清晰地分别观察到穿出股骨颈前曲面、后上曲面及后下曲面的克氏针,而在传统的正、侧位影像上不能发现克氏针完全穿出股骨颈的相应曲面。结论术中传统的正、侧位透视不能精确显示股骨颈整体三维结构。增加适宜投照角度20°位、70°位及170°位,分别可以观察股骨颈前曲面、后上曲面及后下曲面的骨折复位质量和内固定对相应骨皮质损伤。

基于影像组学鉴定头颈部鳞状细胞癌患者HPV状态:诊断性meta分析

目的:采用诊断性meta方法,评价影像组学特征,构建模型,鉴定头颈部鳞状细胞癌患者人乳头瘤病毒(HPV)状态的价值。方法:检索PubMed、Embase、Web of Science、中国知网、维普数据库中有关影像组学鉴定HPV状态的相关文献。检索时间为建库至2022年5月28日。采用Revman5.4等统计软件,评估预测模型的诊断效能。结果:共纳入9篇文献,包括3 312例患者。合并结果显示,基于影像组学方法诊断患者HPV状态的敏感度为0.82 [95%CI(0.74,0.87)],特异度为0.66 [95%CI (0.54,0.75)],阳性似然比为2.4 [95%CI (1.8,3.1)],阴性似然比为0.28 [95%CI(0.21,0.36)],诊断比值比为9[95%CI(6,12)],综合受试者工作特征曲线下面积(AUC)为0.82[95%CI(0.78,0.85)]。通过影像组学方法鉴定HPV状态先验概率为25%,可提升至44%(后验概率)。结论:采用影像组学方法鉴定头颈部鳞状细胞癌患者HPV状态有较高的实用价值。

口腔医学影像检查中甲状腺和晶状体的辐射防护研究

目的:探究口腔医学影像检查中口腔牙片摄影(DP)、口腔颌面计算机曲面断层扫描(COPT)和口腔锥形束立体断层扫描(CBCT)3种口腔影像技术对甲状腺和晶状体的辐射防护价值,指导临床口腔检查时的合理辐射防护。方法:采用仿真成年人头颈体模(简称头颈体模),分别依次在口腔DP、COPT和CBCT检查中对甲状腺和晶状体测试点进行无辐射防护和有辐射防护测试,将无辐射防护测试纳入对照组,有辐射防护测试纳入观察组,采用热释光剂量计(TLD)72支放置于头颈体模的体表的24个测试点(每个点位3支)对两组进行辐射剂量测试,并读出相应测试点入射体表剂量,每个点位3支TLD测试取平均值转换为有效剂量,比较头颈体模的相应测试点的辐射剂量。结果:两组口腔DP、COPT和CBCT检查头颈体模左侧、右侧甲状腺体表各测试点比较,差异有统计学意义(t_(口腔DP)=86.646,t=135.345;t_(口腔COPT)=1164.732,t=1109.619;t_(口腔CBCT)=74.083,t=28.416,P<0.001)。对照组口腔DP、COPT和CBCT检查左侧、右侧眼部体表测试点辐射剂量高于观察组,其差异有统计学意义(t_(口腔DP)=58.788,t=58.788;t_(口腔COPT)=662.587,t=789.500;t_(口腔CBCT)=135.001,t=147.309;P<0.05)。结论:临床中进行口腔DP、COPT和CBCT影像检查时,应对受检者口腔邻近的敏感腺体眼晶状体和甲状腺进行专业性辐射防护。

股骨颈骨折患者护理的安全隐患及人性化护理的临床效果

目的:分析在股骨颈骨折护理过程中存在的安全隐患及采取人性化护理的临床护理效果。方法:选取2019年9月—2020年9月常熟市第一人民医院住院患者80例为研究对象,根据随机数字表法分为对照组与观察组,各40例。对照组给予常规护理,观察组给予人性化护理。比较两组患者护理满意度及临床效果。结果:观察组护理满意度高于对照组,差异有统计学意义(P=0.021)。观察组患者治疗总有效率高于对照组,差异有统计学意义(P=0.025)。结论:股骨颈骨折护理过程中存在一定安全隐患,医护人员应采取人性化护理措施,以提高患者的满意度与治疗效果。

汽车低速碰撞中的人体颈部有限元模型验证

在已有的由湖南大学开发和验证的人体颈部有限元模型的基础上,对其进行诸多改进和优化,并在低速的正面、侧面和后碰撞工况下重新进行验证。模型包括了颈椎椎骨、椎间盘、韧带和肌肉等软组织结构,各个部分分别用不同的单元类型模拟。借助美国海军生物动力学实验室(NBDL)和瑞典查尔摩斯大学进行的实验数据对改进后的模型进行了验证。结果表明:模型在主要响应阶段与实验数据吻合得较好,模型具有较好的生物逼真度。

基于人体测量的羊毛衫领型结构设计

通过先进的非接触式激光三维人体测量，采集了200名19～26岁青年男性颈部相关15个细部尺寸，并利用SPSS统计软件对所采集的数据进行分析，通过因子分析和聚类分析提取了领型结构设计相关的颈部特征尺寸，通过回归分析得到颈部特征尺寸与人体基础部位的回归关系，利用所提取的特征尺寸计算出毛衫领型的设计规格，并采用Primavision辅助羊毛衫设计软件中的吓数纸模块设计出羊毛衫领型样板。

E1A基因对头颈部淋巴结转移鳞癌细胞体外生长的抑制和化放疗增敏的作用

背景与目的:腺病毒5型早期区1A基因(early region 1A,E1A)是新近发现的一个具有抑癌作用的基因,E1A蛋白能够从正、负两种途径调控多种基因的表 达,具有诱导肿瘤细胞分化、逆转其恶性表型、降低其体内致瘤性和抗转移等活性,但E1A基因在头颈淋巴结转移鳞癌治疗中的作用尚少见报道。本研究的目的是探讨E1A基因对头颈淋巴结转移鳞癌细胞体外生长的抑制作用和化、放疗增敏作用及其初步的作用机理。方法:经脂质体介导,将真核细胞高效表达E1A基因的重组质粒peDNA3-E1A导入人舌鳞癌的淋巴结转移癌细胞系686LN-1。通过测绘生长曲线和计算倍增时间,观察E1A基因对该细胞系生长的抑制作用。用MTT法测定转染E1A基因前后,癌细胞对顺铂、泰素、5-氟尿嘧啶和博来霉素等化疗药物以及放疗敏感性的改变。流式细胞术和免疫细胞化学染色检测转染前后的细胞周期分布以及p53和HER-2/neu表达情况。结果:转染E1A基因细胞群体生长缓慢,倍增时间延长(是转染空载体细胞的1.48倍)。与686LN-1-vect比较,686LN-1-E1A细胞对顺铂、博来霉素、泰素和射线的敏感性(IC_(50))分别提高了8倍、20倍、10倍和1倍。细胞周期出现G_2/M期阻滞;免疫细胞化学染色显示E1A基因能抑制HER-2/neu的表达。

人性化护理对头颈部肿瘤放疗患者心理及并发症的影响

目的探讨对头颈部肿瘤放疗患者实施人性化护理对其心理及并发症的影响。方法将我院2011年1月~2013年1月收治的200例头颈部肿瘤患者按照1：1比例随机分为两组各100例,对照组给予常规护理,观察组给予人性化护理,并对两组患者护理前后的心理及并发症情况进行统计学分析。结果护理干预后,观察组SCL-90总评分及各因子评分均显著低于对照组（P〈0.05）;且QOL总分、躯体机能、心理活动和社会活动分数均显著低于观察组（P〈0.05）;对照组放射治疗并发症发生率为18.00%,观察组为7.00%,观察组并发症发生率明显低于对照组（P〈0.05）。结论人性化护理可明显改善头颈部肿瘤患者的心理状况,提高患者的生活质量,有效降低放疗并发症的发生,临床中值得借鉴及推广应用。